Implosive therapy: characteristics and applications

There are various psychological techniques for the treatment of phobias, although it is known that the most effective are the techniques that expose the subject to the phobic stimulus (exposure techniques).

Today we will know one of them, implosive therapy, a mass exposure technique proposed by Thomas Stampfl in 1961.

• Related article: "Types of psychological therapies"

exposure techniques

Exposure techniques are used to treat above all fears and phobias. They consist of exposing the subject to the phobic object or situation, so that he gets used to the anxiety (that he learns to tolerate it) that he feels when exposing himself to it.

The objective is that he learns that there is no harm and therefore the stimulus is not dangerous.

For example, it would be about exposing a person to the dark and understanding that it is not dangerous, or exposing a person with a phobia of dogs to one and seeing that it does not bite.

In any case, in most phobias, the person knows that this fear is irrational, and that the phobic stimulus (or situation) is not really dangerous; however, the person is unable to eliminate the phobia spontaneously if he is not exposed to it and understands that "non-association".

Item hierarchy

Let's see the first step of exposure techniques.

To apply an exposure technique, First, a hierarchy of stimuli should be designed based on the level of anxiety they produce..

Subsequently, the patient should first be exposed to the items that cause less anxiety, and go up the scale of items (from less to more anxiety). The hierarchy will be elaborated by the patient together with the therapist.

Difference with systematic desensitization

Unlike systematic desensitization techniques (where the patient applies a anxiety-incompatible response, such as relaxation, to stimulus exposure phobic), in exposure exposure to stimuli is less gradual (the hierarchy is more abrupt).

Mass exposure techniques

Within the exposure techniques, we find various types according to the type of exposure (live exposure, symbolic, through virtual reality...).

On the other hand, implosive therapy is within the modality of massive exposure, where therapeutic sessions are 1 or 2 hours a day for 7 consecutive days. In this sense, massive exposure techniques are more effective techniques than spaced exposure techniques (for example, with sessions 1 or 2 days a week).

In turn, we find two types of mass exposure techniques: implosive therapy and flood therapy.

implosive therapy

Implosive therapy was created by Thomas Stampfl in 1961. Its theoretical basis is based on psychoanalysis and experimental psychology. (unlike the flood, which we will see later, and which is based solely on experimental psychology).

Exposure to aversive stimuli is done solely through imagination, and the escape response is not allowed. In the flood, on the other hand, the exposure can be live or imagined, and the escape response is possible. The content of the stimuli is a dynamic content.

On the other hand, the stimulus presentation hierarchy is less gradual than in flooding, that is, it is easier to go from a less aversive stimulus to a more aversive one, the change is more abrupt.

• You may be interested in: "Types of Phobias: Exploring Fear Disorders"

flood therapy

Similar to the previous one, but with the differences mentioned, is the flood therapy, created by Baum in 1968. As we have seen, here the theoretical bases focus on experimental psychology, and exposure to stimuli can be both live and in imagination. The escape response may or may not occur during exposure, and the content of the stimuli is realistic.

Both implosive therapy and flood therapy can use the nested presentation of stimuli, but this is less demanding and graduated than in systematic desensitization (SD), more abrupt

exposure guidelines

When a subject is exposed to a phobic situation through implosive therapy and he continues to present anxiety at the time of its application, the phobic stimulus should continue to be maintained. In the event that the phobia is excessive, then escape to a calm situation will be allowed (only in the case of flooding).

In the case of implosion, the presentation of the stimulus will continue until the anxiety is reduced, and in the next session will start with a previous item in the hierarchy, since the last one will not be considered overcome.

Variants and their level of effectiveness

Depending on the characteristics of the exposure technique that we are going to use, there are differences in the degree of effectiveness. Let's see them:

Live and symbolic exhibition

As we have seen, in implosive therapy phobic stimuli will always be presented in the imagination. However, it should be noted that the most effective exposure techniques are those that present the stimulus in vivo (in real form).

exposure gradient

It is known that the maximum efficiency occurs when the gradient or intensity of exposure to stimuli is as abrupt as the patient can tolerate; In this case, implosive therapy would be a good therapeutic option to eliminate phobias, especially if they are to be eliminated quickly.

In any case, a gradual intensity will also be effective, although an abrupt one will offer faster results (but it does not have to be more effective; that will depend on the type of patient).

interval between sessions

When defining massive exposure techniques, we have also seen that implosive therapy is applied daily (the interval between sessions is short). Therefore it will be more effective than if the interval between sessions is long (frequency of weekly sessions, for example).

Session duration

In implosive therapy sessions last between 1 and 2 hours. It is known that the effectiveness is maximum when the duration is as long as necessary to facilitate the habitation (between 30 and 120 minutes). Therefore, in this sense, this technique will be one of the most effective.

However, it should be noted that applying an overexposure from the moment the fear does not disappear does not improve the results.

Bibliographic references:

• Horse, v. (1991). Manual of Therapy Techniques and Behavior Modification. S. XXI: Madrid
• Labrador, F.J. et al. (1993). Manual of Behavior Modification and Therapy Techniques. Pyramid: Madrid